Medical school: RUTGERS NEW JERSEY MEDICAL SCHOOL
Graduated: 1979
NPI: 1841201936
Practice Locations (3)
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
59 KOCH AVE
MORRIS PLAINS, NJ 079504400
9735381800
115 ROUTE 46 WEST BUILDING D, SUITE 27
MOUNTAIN LAKES, NJ 070461671
9733343345
115 RT 46, BLDG D SUITE 27
Mt. Lakes, NJ 070461671
Source: CMS National Downloadable File, September 2026.